As you may know, there are national initiatives to improve consumer awareness of certain conditions, diseases, etc. This year, we are going to blog about initiatives that can affect the eyes or vision, in conjunction with those national initiatives. No better time than the present to start!
January is Glaucoma Awareness Month. Glaucoma is a progressive loss of peripheral vision. The scary thing is the majority of individuals with glaucoma do not experience symptoms. Obviously, the common thought is “well if the person is asymptomatic, why does it matter?” Early detection and treatment of glaucoma is important because if left untreated symptoms will occur. Symptoms associated with glaucoma are decreased peripheral vision and progression to blindness. A person can lose 40% of their vision before they are symptomatic. This decrease can greatly affect activities of daily living and unfortunately once the vision is lost is cannot be regained. These symptoms may start as missing objects or not seeing in their peripheral (side) vision and will progress to tunnel vision.
So what is glaucoma? Glaucoma is damage to the optic nerve that can be secondary to increased pressure inside the eye. There is a flow of fluid inside the eye, this fluid is called aqueous. Aqueous is a clear fluid that helps maintain the shape and integrity of the eye. Aqueous drains from the eye at the junction where the cornea (clear front surface of the eye) meets the sclera (white, tough, outer surface of the eye). The outflow of aqueous is very important. If the outflow of aqueous is slower than the production of aqueous it can increase the pressure inside the eye. This pressure (intraocular pressure) damages the axons that come together to form the optic nerve. The intraocular pressure can be impacted by elevated blood pressure. People who are at risk of having glaucoma and have uncontrolled blood pressure should work with their primary care physician to control blood pressure.
It is important to mention that glaucoma can occur without increased pressure inside the eye. This can be called normal tension or low tension glaucoma. A recent study determined that about one third of all glaucoma cases are normal tension glaucoma. Glaucoma is also not always a bilateral (both eyes) condition, it can be a unilateral (one eye) condition.
According to the World Health Organization, glaucoma is the second leading cause of blindness in the world, secondary to cataracts. In the United States alone it is estimated that three million people have glaucoma. The National Eye Institute predicts that by 2030 this number will increase by fifty-eight percent. Talk about a huge increase!
Anyone is susceptible to developing glaucoma. There are individuals who have a higher risk of developing glaucoma. Age is a risk factor, anyone over the age of sixty, especially for individuals who are Hispanic/Latino. African Americans are at a higher risk over the age of forty. A positive family history (someone else in the family has glaucoma) increases the risk of developing glaucoma.
So what can be done about glaucoma? Currently, there is no cure for glaucoma but there are treatments to slow progression. Realistically step one is identifying risk factors. This identification process begins with an annual comprehensive eye examination. Because glaucoma is a slowly progressive disease annual monitoring and documentation of ocular health is important. If there are “red flags” that come up during a comprehensive eye examination further testing is indicated. These tests provide more detailed information about changes that may be impossible to detect with the visualization. Baseline glaucoma testing should include a threshold visual field (peripheral vision test, see our previous blog), optical coherence tomography (cross-sectional scan of the optic nerve, see our previous blog), gonioscopy (a detailed view of the aqueous drainage in the eye), and a fundus photograph (photo of the optic nerve and macula). The earlier changes are detected in the eye the sooner treatment can be initiated.
January is Glaucoma Awareness Month, this year don't take your eyes for granted. Let 2017 be the year of preventative care and better health.